Facial Surgery

Rhinoplasty (Nose Job)

The nose is one of our most prominent facial features, and because of this any defects are easily noticed. For those who are dissatisfied with their nose's appearance, rhinoplasty is an option of treatment. Rhinoplasty is a nose reshaping surgery often referred to as a “nose job”, and it is one of the most popular procedures performed worldwide. It is a very versatile procedure that can make significant changes to the nasal aesthetics, and also improve nasal function in people who have breathing problems. Because the nose is one of the first features people notice, nasal aesthetics have a huge impact on facial balance and the harmony between the facial features.

Improving the overall aesthetics of the nose can boost confidence and self-esteem. Functional rhinoplasty can help improve quality of life through improved breathing, and can even help with disorders such as sleep apnea and snoring. Nasal surgery is highly customizable and is performed to suit the specific needs and facial features of each patient.

Some common problems that rhinoplasty can address include:

Hump on the nasal bridge (dorsal hump)

Crookedness

Deviated septum

Bulbous/undefined nasal tip

Too large/too small nose

Wide nasal bridge

Common nasal deformities

Rhinoplasty Consultation

Rhinoplasty is an extremely complex and custom procedure that requires the skill of an expert rhinoplasty surgeon, like our talented doctors in Atlanta, GA. An in-person consultation is the first step in getting a beautiful outcome, and because the rhinoplasty procedure is so custom, effective communication is an essential part of the process. A consultation will help ensure that you and your surgeon are on the same page about the desired outcome of the surgery.

During your consultation, you will discuss your goals for surgery, and have your nose assessed by one of our highly trained cosmetic surgeons. You will also have your candidacy assessed and have the opportunity to ask questions about your procedure. Use your consultation time wisely—it's a valuable opportunity for you to get to know your surgeon and plan your procedure.

Rhinoplasty Candidates

While there is no upper age limit on rhinoplasty, the procedure is most popular among young adults. Most people who choose cosmetic nasal surgery have disliked their nose for years and try to take action to fix the problem as soon as they can. Good candidates for rhinoplasty are healthy, non-smoking adults with aesthetic or functional issues of the nose. Candidates should have realistic expectations about the results of rhinoplasty, and be willing to follow all pre- and post-operative instructions.

Rhinoplasty Procedure

Because rhinoplasty is a complex and custom surgery, the procedure is never performed in exactly the same way twice. Surgeons take an artistic approach to cosmetic nasal surgery and use a variety of techniques as needed to reach the patient's goals. Rhinoplasty is typically performed under general anesthesia, and takes a few hours to complete. Incisions are very small, and are made either between the nostrils externally, or inside the nostrils. Techniques that may be used during the surgery include:

Cartilage grafting

Straightening of the nasal septum

Bone rasping

Osteotomy (breaking the nose)

Nostril re-positioning

Once the surgery is complete, the incisions are closed and a splint is placed on the nose to protect it for the first few days. Nasal packing is generally unnecessary.

Rhinoplasty Recovery

The initial recovery period from nasal surgery is uncomfortable, but generally not as bad as patients expect. Pain can be controlled with prescribed medication, and remedies like Arnica and Bromelain can help with swelling. The dressings and stitches on the nose will remain in place for about a week, and patients will need to keep their head elevated and avoid anything that might put strain on the nose and the incisions, including bending over, wearing glasses, blowing the nose, smiling/laughing, and vigorous tooth brushing.

After the first one to two weeks, patients can begin to resume normal activities, and can usually go back to a desk job. Bruising will fade over a few weeks, but swelling from the procedure takes longer to resolve. Initial swelling will mostly subside in the first month or two after surgery, but residual swelling can take up to a year to resolve fully. Patients can help encourage a good outcome by following all post-operative instructions provided by the surgeon.

Rhinoplasty FAQs

Many young people have hated their nose for years and are interested in pursuing nasal surgery. However, if you're under 18, it can be risky to undergo rhinoplasty due to the way nasal growth progresses. The nose is a fairly slow-maturing part of the body, and reputable rhinoplasty surgeons will usually refuse to operate on patients under the age of 15 or 16, even with parental consent. This is because the nose does not finish maturing until age 15-16 in girls and 16-17 in boys. In general, it is best to wait until you are at least 18 years old to undergo rhinoplasty to be sure your results will not be ruined by additional growth of the nose after surgery.

Cartilage grafting is an essential part of nearly every rhinoplasty procedure, and the cartilage used to reshape the nose is taken from other areas of the patient's body. The ideal cartilage for harvest is located in the nasal septum. This cartilage is strong, flexible, and ideal for shaping the rest of the nose. Septum cartilage has the added bonus of requiring no extra incisions to retrieve it. If there is not enough cartilage in the nasal septum, there are two other sources that can be used: the ear or the rib. Grafts using ear or rib cartilage are usually very successful, and surgeons use them often if the need arises.

Most surgeons today prefer to use cartilage grafts whenever possible, but in some cases, it is best to use a nasal implant, typically made of silicone or Gore-Tex. Nasal implants can build up and shape the nose, and are most often used to build up a short nose.

Breaking the nose during rhinoplasty is known as “osteotomy”, and while it's not used in every single procedure, it is an essential technique in nasal surgery, and must be used to accomplish some goals. Osteotomy may sound scary, but the recovery is not much different than for a rhinoplasty performed without osteotomy. Patients may experience more bruising following surgery, but osteotomy is a safe and common technique.

In the context of nasal surgery, “open” vs. “closed” simply refers to the surgical technique used—whether or not an external incision is used. In a closed rhinoplasty procedure, the surgeon makes all of the incisions inside the nose. This eliminates visible scarring, but makes it more difficult to perform the operation. During an open rhinoplasty, a small incision is made between the nostrils, so that the nose can be opened up and accessed with ease. A small visible scar that fades over time is all that remains.

The open vs. closed argument in modern rhinoplasty leans much more toward the open rhinoplasty, as this approach gives surgeons greater access and visibility during surgery, which allows them to provide more consistent and impressive results. For this reason, most surgeons recommend the open technique in the majority of rhinoplasty cases.

The initial rhinoplasty recovery time is fairly brief, but it takes a while for patients to be able to safely resume activities like strenuous exercise. As soon as possible following surgery, you should start light activity like walking, but you will have to wait several weeks to get back to activities such as running, weight lifting, and other forms of exercise. The recovery period differs from patient to patient, but it is best to be cautious when returning to exercise, particularly with activities such as weight lifting, swimming, and contact sports, in order to promote successful healing, avoid complications, and prevent injury.

There is no way to exactly copy a nose, although surgeons can come close. However, it is not advisable to mimic someone's nose, as beautiful noses are not “one-size-fits-all.” This means that what looks good on one person might not work for someone else due to facial balance and incompatibility of the facial features. For this reason, you should be very careful when considering copying someone's nose—you might end up dissatisfied with the results.

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